Special response team follows up on overdoses
SALISBURY — Since the Post Overdose Response Team became active less than a month ago, Rowan County emergency crews have treated 22 people for drug overdoses in 25 days — some more than once, and nearly all involving heroin. One died.
The goal of the response team — PORT, for short — is to keep the overdose survivors alive and eventually recovering.
“We’re not foolish enough to think we’ll reach 100 percent,” paramedic Jeff Brown said Thursday. “But we’re foolish enough to try.”
Brown was among the speakers Thursday at Rowan County’s third annual meeting spurred by the opioid epidemic, now expanded to be called a Substance Abuse Forum. It was sponsored by the Rowan County Health Department and YSUP, the Youth Substance Use Prevention program.
The 100-plus in attendance heard several speakers detail what Rowan County is doing to reverse the opioid crisis, from drug drop-off boxes to Narcan kits and a response team.
A recent Post headline said overdose deaths in the county are down, said Health Director Nina Oliver, but that gives people the wrong idea. Deaths may have declined because more people are being saved by the overdose-reversing drug Narcan, she said, but addiction is as prevalent as ever, if not more so.
“We want so much to know what the magic solution is, but there isn’t one,” Oliver said.
Part of the answer, though, may be the PORT team.
The one in five recent overdose patients that the PORT team has reached since July 15 came away from the encounter with new tools to fight addiction. Team members provided education for the patient, family and friends about how to prevent an overdose and whom to call in a crisis. The team gave them Narcan kits and told the users about needle exchange programs.
And they presented treatment options so that, when ready, users can enter recovery.
Brown, the paramedic, is part of Rowan County’s first PORT team, serving with Ashley Creek, a peer support specialist with the Health Department, and Neetu Verma, a harm reduction specialist with the Center for Prevention Services.
Brown presented scenarios in which fictional characters Jane and John overdosed on heroin laced with fentanyl. Found unconscious, barely breathing and near death, the two were revived with oxygen and naloxone. They refused transportation to the hospital but accepted Narcan kits. Told that they should expect a call from the PORT team, they both agreed to meet with team members.
Jane obviously had hit rock bottom, Brown said. She was disgusted with herself for the things she’d done to get drugs. She said she was no longer using to get high; she had to have heroin just to feel normal and not get sick. She was ready for change and expressed a desire for help. Members of the PORT team helped her find appropriate treatment, and now she’s on Suboxone to keep her comfortable while she goes through detox.
“Jane is determined to be free of her demon,” Brown said.
John, on the other hand, was a party guy who was not ready or willing to leave his drug habits behind, Brown said. The PORT team gave him a Narcan kit, brochures and contact information. He agreed to not use while he’s alone and to take part in a syringe exchange program so he won’t used dirty or shared needles. These actions decrease the chances he’ll have a fatal overdose or contract HIV or hepatitis C. A community paramedic will check on him from time to time. His PORT encounter is a step toward recovery, even though he still intends to use.
PORT efforts are funded by a two-year, $285,326 grant the Health Department received from Blue Cross and Blue Shield of North Carolina. The PORT team is designed to intervene directly with people affected by overdoses to provide outreach and support.
So far, three of the people PORT has called on since mid-July are in recovery, Brown said.
Initiatives like the PORT team and needle exchange program are part of the nationwide harm reduction movement. Built on a belief in and respect for the rights of people who use drugs, harm reduction aims to meet addicts where they are with a range of strategies, from safer use to managed use to abstinence and recovery. The nonjudgmental approach aims to bring about change in drug users’ behavior — even incremental change.
Success would save lives and money, Oliver said. Unchecked, substance abuse can spread HIV/AIDS and hepatitis, harm unborn children and lead to death. It increases crime, unemployment, domestic abuse, child neglect and homelessness.
Nationally, these addictions have cost billions in reduced work production, increased incarceration and premature deaths, she said.
Greg Edds, chairman of the Rowan County commissioners, said worst of all the problem is decimating families and hurting people.
Karen South Jones, director of the Youth Services Bureau, explained YSUP Rowan strategies to prevent youth substance abuse. She also had a mock teen bedroom set up with signs of drug use “hidden in plain sight” where parents might overlook them. YSUP needs a trailer to take the display around the county, she said.
Donna Fayko, director of the Rowan County Department of Social Services, said substance abuse has hurt children who both learn the behavior and endure neglect because of their parents’ use. These children suffer lasting damage from the trauma that surrounds their lives, even affecting brain development. The number of children entering foster care has increased nationwide.
Among the steps taken in Rowan County to intervene in and fight substance use disorder are:
• Ten medicine take-back boxes across the county have taken in almost 4,000 pounds of medications since January 2017.
• Free Narcan kits are available to anyone who presents a need at the Health Department at 1811 E. Innes St. Since May 2018, more than 50 have been given out — to users, family members and friends — along with advice from a trained nurse on how to use the kit.
• A 60-page guide to local prevention and treatment programs has been put together by the Health Department, the Center for Prevention Services and Cardinal Innovations. It’s available online and at the Health Department.
• Testing for communicable diseases linked to drug abuse has increased at the Health Department, the Community Care Clinic and the county jail. Oliver said last week, 181 people in the jail received hepatitis vaccine.
• Users are being directed to a syringe exchange program at the Cabarrus Health Alliance in Kannapolis.
• Recovery support groups have been made available at Daymark Recovery Services.
• A Substance Use Task Force has been formed, along with a Harm Reduction Action Team.
• Ads in the Salisbury Post during National Drug & Alcohol Facts Week in January spread awareness of substance issues, including the dangers of e-cigarettes being marketed to children.
• Seminars have been presented to groups, such as Rowan-Cabarrus Community College employees and students.
• Billboards have gone up on Interstate 85 reminding drivers of the potential for arrest if they drink. “Drink. Drive. Go to Jail,” they say.
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